• Title/Summary/Keyword: Gynecology department

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Efficacy of methotrexate therapy in patients with tubal pregnancy and a serum human chorionic gonadotropin level above 10,000 IU/L

  • Kim, Kidong;Suh, Dong Hoon;Cheong, Hyun Hoon;Yoon, Sang Ho;Lee, Taek-Sang;No, Jae Hong;Kim, Yong-Beom
    • Clinical and Experimental Reproductive Medicine
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    • v.41 no.1
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    • pp.33-36
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    • 2014
  • Objective: To estimate the failure rate of medical treatment and to identify variables associated with treatment failure in patients with tubal pregnancy and an initial serum level of human chorionic gonadotropin (HCG) over 10,000 IU/L. Methods: The inclusion criteria were tubal pregnancy diagnosed using ultrasonography, primary treatment of intramuscular methotrexate injection at one of the four institutions between January 2003 and December 2011, a serum HCG level within two days before treatment >10,000 IU/L, and follow-up data to determine treatment success or failure. Exclusion criteria were other primary treatments besides intramuscular methotrexate injection. The clinicopathologic data of 36 patients were collected and analyzed. Results: Medical treatment failed and surgery was performed in 19 (53%) patients. In univariable analysis, age, parity, and size of the gestational sac were associated with treatment failure, but none of the variables were associated with treatment failure in multivariable analysis. The failure rate in the subgroup with age<33 years and size of gestational sac ${\geq}1.1cm$ was significantly higher than those of the other subgroups (82% vs. 41% [mean of the other subgroups], respectively). Conclusion: Patients with a serum HCG level >10,000 IU/L who received medical treatment had a high failure rate. Among them, patients aged<33 year and with a gestational sac ${\geq}1.1cm$ had an extremely high failure rate.

Causes of amenorrhea in Korea: Experience of a single large center

  • Kwon, Su-Kyoung;Chae, Hee-Dong;Lee, Kyung-Hee;Kim, Sung-Hoon;Kim, Chung-Hoon;Kang, Byung-Moon
    • Clinical and Experimental Reproductive Medicine
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    • v.41 no.1
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    • pp.29-32
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    • 2014
  • Objective: To investigate the causes of amenorrhea in Korean women. Methods: Medical records from 1,212 women with amenorrhea who visited the Department of Obstetrics and Gynecology, Asan Medical Center, between January 1989 and December 2011 were retrospectively reviewed. Amenorrhea was categorized as either primary or secondary. Results: Primary amenorrhea was identified in 132 of the patients (10.9%) and secondary amenorrhea in 1,080 (89.1%). The most frequent causes of primary amenorrhea were gonadal dysgenesis (28.0%, 37/132); Mayer-Rokitansky-K$\ddot{u}$ster-Hauser syndrome (20.0%, 27/132); and constitutional delay and androgen insensitivity syndrome (8.3%, 11/132; 8.3%, 11/132, respectively). Secondary amenorrhea was due to polycystic ovary syndrome (48.4%, 523/1,080); premature ovarian insufficiency (14.0%, 151/1,080); and nutrition-related hypogonadotropic hypogonadism (8.3%, 90/1,080). Conclusion: In this retrospective study, gonadal dysgenesis was the most common cause of primary amenorrhea and polycystic ovary syndrome was the most common cause of secondary amenorrhea in Korean women.

Macrophage Migration Inhibitory Factor (MIF) Concentration in the Serum of Patients with Ovarian Cysts for Differential Diagnosis of Endometrioma (자궁내막종의 감별진단을 위한 난소낭종 환자의 혈청 Macrophage Migration Inhibitory Factor (MIF) 농도의 진단적 유용성에 대한 연구)

  • Kim, Man Ki;Kim, Yu Re;Hong, Seong Hwa;Park, Yeon Jin;Ji, IL Woon;Jeong, Eun Hwan;Kim, Hak Soon
    • Clinical and Experimental Reproductive Medicine
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    • v.32 no.3
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    • pp.287-293
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    • 2005
  • Objective: To evaluate the usefulness of serum concentrations of macrophage migration inhibitory factor (MIF) of patients with ovarian cysts for differential diagnosis of endometrioama. Method: From Jan. 2003 to Dec. 2004, preoperative serum MIF levels were assessed in 28 women with endometrioma, 32 with benign epithelial tumor, 23 with functional and simple cysts, 22 with benign mature cystic teratoma, and 25 women without ovarian tumor as control. MIF levels were determined using an ELISA (Quantikine Human MIF immunoassay, R&D Systems, Inc., USA). Results: Mean MIF levels were higher in all groups with benign tumors than control (all p<0.01), but there was no significant difference between benign tumor groups (p=0.95). There was no significant correlation between MIF levels and tumor volume, body mass index (BMI) (p=0.635, 0.674 respectively) Serum MIF level had significant correlation with count of WBC and neutrophils (p=0.008, 0.024 respectively), but had no correlation with count of lymhocytes and monocytes (p=0.688, 0.294 respectively). Conclusions: This study showed a marked increase in MIF concentrations in the peripheral blood of patients with endometrioma, but there was no significant difference with other benign tumors. Serum MIF level had significant correlation with count of WBC and neutrophils. These suggest serum MIF level has no usefulness for differential diagnosis of endometrioma from other benign ovarian cysts.

A Case of Pregnancy from Cryopreserved Embryos following ICSI with Frozen-Thawed Epididymal Sperms (동결보존된 부고환 정자로 ICSI 시술 후 수정된 수정란의 동결보전 및 배아이식에 의한 임신 1례)

  • Moon, S.Y.;Lee, H.S.;Kim, H.S.;Ryu, B.Y.;Pang, M.G.;Oh, S.K.;Suh, C.S.;Kim, S.H.;Choi, Y.M.;Kim, J.G.;Lee, J.Y.
    • Clinical and Experimental Reproductive Medicine
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    • v.24 no.2
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    • pp.273-277
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    • 1997
  • This case report describes the pregnancy following the transfer of cryopreserved embryos generated from intracytoplasmic sperm injection (ICSI) using frozen-thawed sperm obtained by microepididymal sperm aspiration (MESA) in patient with congenital absence of the vas deferens (CAVD).

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Prevalence and confounders of chronic endometritis diagnosed using CD138 in patients with recurrent implantation failure

  • Hye Jeong Hue;Hyunji Choi;Hyun Kyoung Lee;Jung Ryeol Lee;Byung Chul Jee;Chang Woo Choo;Seul Ki Kim
    • Clinical and Experimental Reproductive Medicine
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    • v.51 no.2
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    • pp.163-169
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    • 2024
  • Objective: This retrospective study aimed to investigate the prevalence of chronic endometritis, diagnosed using CD138 immunohistochemistry, among infertile women and to assess the association between chronic endometritis and recurrent implantation failure (RIF). Methods: In total, 266 patients who underwent hysteroscopy due to infertility between 2019 and 2020 were included in the analysis. Of these, 136 patients with RIF and 130 non-RIF patients were included in the study. CD138 immunohistochemistry test results, blood biomarkers (including natural killer cells, white blood cells, and the lymphocyte-to-neutrophil ratio), and data on pregnancy outcomes were obtained. If the CD138 test yielded a positive result, the patients received antibiotic treatment. Results: The overall proportion of CD138-positive patients was 32.7% (87/266). The CD138 positivity rate was not related to the number of cycles with implantation failure. In the RIF patient group, no significant associations were found between CD138 positivity and peripheral blood markers. The clinical pregnancy rates were similar between infertile women treated with antibiotics for chronic endometritis and those without chronic endometritis. Conclusion: To improve the pregnancy rate in infertile patients, it may be helpful to combine CD138 testing with other laboratory tests and administer antibiotic treatment if the result is positive.

Iliopelvic Lymphoscintigraphic Findings in Carcinoma of Uterine Cervix (자궁경부암 환자에서의 Lymphoscintigraphy 소견)

  • Lim, Sang-Moo;Hong, Sung-Woon;Park, Sang-Yun;Lee, Je-Ho;Lee, Eui-Don;Lee, Kyung-Hee;Park, Kee-Bok;Choi, Chang-Woon
    • The Korean Journal of Nuclear Medicine
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    • v.24 no.2
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    • pp.286-292
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    • 1990
  • Iliopelvic lymphoscintigraphy was performed to visualize the changes of the lymphatic system using Technetium-99m antimony sulfide colloid in carcinoma of uterine cervix. There were no differences between various indices and clinical stages, but comparison with computed tomographic and postoperative findings, there was meaningful difference in index of decrease and increase, respectively. And lymphoscintigraphy showed by pass way of lymphatic channel in 42 cases (16%) and this suggested the presence of normal shunts of lymphatic channels. Iliopelvic lymphoscintigraphy may be useful for evaluation of lymphatic system in carcinoma of uterine cervix, expecially for screening method.

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Rapid prenatal diagnosis of Down syndrome and Edward syndrome by fluorescence In situ hybridization : Clinical experience with 309 cases (FISH를 이용한 다운증후군과 에드워드증후군의 신속한 산전확인 : 309예의 임상적 고찰)

  • Kang, Jin-Hee;Lee, Sook-Hwan;Park, Sang-Hee;Park, Ji-Hyun;Kim, Ji-Youn;Han, Won-Bo;Kim, In-Hyun;Park, Sang-Won;Jang, Jin-Beum;Lee, Kyoung-Jin;Park, Hee-Jin;Jun, Hye-Sun;Lee, Kyung-Ju;Shin, Joong-Sik;Cha, Dong-Hyun
    • Journal of Genetic Medicine
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    • v.4 no.1
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    • pp.64-71
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    • 2007
  • Purpose : The purpose of this study was to evaluate the clinical utility of rapid detection of Down syndrome and Edward syndrome by Interphase Fluorescence in Situ Hybridization (FISH) analysis. Methods : Aretrospective study in 309 cases of amniotic fluid samples, analysed by interphase FISH with DNA probes specific to chromosome 18 and 21, was performed. All FISH results w ere compared with conventional cytogenetic karyotypings. Results : The results were considered as informative and they were obtained within 48 hrs. A case of Down syndrome and a case of Edward syndrome were diagnosed by FISH and confirmed by subsequent cytogenetic analysis. In 12 cases with normal FISH results, the cytogenetic analysis showed a case of partial trisomy 22, three cases of sex chromosomal aneuploidy, two cases of mosaicism, two cases of microdeletion, and four cases of structural rearrangement. Conclusion : FISH is a rapid and effective diagnostic method, which can be used as an adjunctive test to cytogenetic analysis, for prenatal identification of chromosome aneuploidies. For the more genome-wide screening with variety of probes, the technique of FISH is both expensive and labor-intensive.

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